HEALTH & SCIENCE

New approaches aimed at healing wounds

A diverse group of researchers is exploring the biology of this process.

By Susan J. Landers, AMNews staff. Jan. 14, 2008.

Washington -- Wounds may result from a gunshot, diabetes, a burn or a bedsore, but they all signal the body's healing mechanism to proceed through a series of complex steps. Four new centers have been funded to develop innovative therapies to both ease and speed this process.

The National Institute of General Medical Sciences, which is part of the National Institutes of Health, recently awarded $13 million over four years to an interdisciplinary group of 36 investigators at eight universities and medical centers who are studying diverse approaches to wound healing.

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Collectively, chronic wounds cost the nation $20 billion to $25 billion a year, and acute or traumatic wounds add another $7 billion to $10 billion annually, said Richard Ikeda, PhD, program director of the wound healing research portfolio at NIGMS. The problem is likely to become more costly with an aging population, because older skin heals more slowly and tends to have more problems in general, he added.

Although there has been a lot of progress in the wound-healing field -- new antibiotics, high-tech bandages and even skin substitutes for very problematic wounds -- there is only one product on the market, a growth factor, that targets the biology of wound healing, Dr. Ikeda said.

"When you think about cancer or infectious diseases, the tack has been to target the biology, to look at what you would target to either cure the cancer or cure the infectious disease. But in wound healing, we know a lot about it but we haven't been successful at targeting the biology to improve wound healing."

That circumstance could change if the centers are successful in their endeavors. A wide array of approaches is being undertaken. Among them:

Andrew Baird, PhD, a molecular biologist at the La Jolla Institute for Molecular Medicine in San Diego, Calif., is leading a group that will combine mathematics and biology to evaluate simultaneously millions of molecules for their capacity to speed up the normal healing process. Originally developed by cancer researchers to target tumors, this method allows investigators to mine huge libraries of molecules to find those with new and improved biological activities.

Promising molecules will be used to enhance the activity of growth factors that accelerate healing, deliver gene-based medicines to promote tissue repair and study how stem cells in bone marrow contribute to tissue regeneration.

Luisa A. DiPietro, DDS, PhD, director of the Center for Wound Repair and Regeneration at the University of Illinois at Chicago College of Dentistry, will guide a study on wound healing in mucosal tissues. These tissues, found in the mouth as well as in the genital and digestive tracts, heal more quickly and with less scarring than does skin tissue. The goal is to develop drugs that reduce scarring.
Gregg L. Semenza, MD, PhD, professor of pediatrics at Johns Hopkins University School of Medicine in Baltimore, Md., will lead a study on how endothelial progenitor cells can speed healing and reduce scarring in burn wounds. These cells are produced in bone marrow and are essential to rebuilding blood vessels, which are needed to repair injured tissues. The researchers will test ways to promote this natural healing by turning on a specific set of genes that recruit the cells to the wound site.
Philip S. Stewart, PhD, director of the center for biofilm engineering at Montana State University in Bozeman, will guide an examination of microbial biofilms, which are thin layers of bacteria that impede the healing of chronic wounds. The biofilms are complex communities of interacting bacteria and other microorganisms, and when they collect on dead or damaged tissue, they can resist antibiotics and immune system defenses. The research team will study the incidence and microbial makeup of biofilms in chronic wounds and test treatments to disrupt their effects.

This research also could help in treating other conditions in which biofilms are thought to play a role, such as ear infections and inflammation of the sinuses, bones and lining of the heart.